Early obesity puts children at increased risk for adult obesity, cardiovascular disease (CVD), early mortality, and other risks relative to normal weight children. Most parents of obese children are not concerned about their child's weight, and parents grossly underestimate the probabilities that their child will be obese and develop CVD in adulthood. Parents of obese children who have enrolled in obesity treatment programs cite a desire to improve their child's long-term health as a reason for engaging in behavior change. Concern about a child's health may be an important facilitator for behavior change engagement. Therefore, we are interested in understanding ways to promote accurate understanding of children's long-term health risks in order to raise an appropriate level of concern about obese children's weight and increase uptake of healthful behaviors. Health care providers are essential to help parents understand whether their child is on a healthy weight trajectory, but providers do not have effective tools for talking to parents about obesity and its associated adverse health risks; BMI growth charts alone are insufficient. This proposal's overall research goal is to identiy clinic-based risk communication approaches that can motivate parents of obese children to engage in behavior change to prevent future obesity and CVD. In Aim 1, we will develop novel risk communication messages. We will consider several novel approaches around message content and framing, but primarily, we propose using microsimulation models to forecast a child's long-term health risks, based on his age, race, gender, BMI, and family history of CVD. Qualitative interviews with providers and parents, and a stakeholder panel comprised of health researchers and parent research partners, will be used to evaluate potentially effective and acceptable messages. In Aim 2, we will experimentally evaluate the efficacy of four novel risk communication messages on parental behavior change willingness and intent using a national web-based survey. Finally, in Aim 3, we will test the acceptability and effectiveness of new risk communication messages in a clinical setting, and we will observe the impact of new messages on behavior change activities. A survey will assess parent-perceived risks, perceived message accuracy, concern about child health, and anxiety. This research plan is part of a K01 proposal designed to provide scholarly training, mentorship, and support for Dr. Wright to gain skills and experience needed to conduct research on how improved obesity-related risk communication messages may affect child behavior change. Dr. Wright is a decision scientist whose career goal is to become an independent investigator with a focus on using decision science methods to motivate uptake of childhood obesity treatment and behavior change. To achieve this objective, she will pursue training in: (1) the psychology of medical decision making and principles of pediatric risk communication, (2) qualitative research methods, and (3) the design, implementation, and evaluation of behavioral health interventions. (End of Abstract)